AMBOSS INTERNAL MEDICINE EXAM 3 TESTBANK LATEST COMPLETE 700 REAL QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (CORRECT VERIFIED SOLUTIONS) LATEST UPDATED VERSION

Internal Medicine Practice Exam (100% Errorless)
G G G G G




AG24-year-
oldGwomanGpresentsGwithGcomplaintsGofGexcessiveGthirstGoverGtheGpastGseveralGweeks.GSheGalsoGn
otesGwakingGupGinGtheGmiddleGofGtheGnightGtoGurinate.GSheGrecentlyGunderwentGtranssphenoidalGre
sectionGofGaGpituitaryGadenoma.GWhichGofGtheGfollowingGisGtheGmostGlikelyGdiagnosis?

A.GCentralGdiabetesGinsipidus
B.GNephrogenicGdiabetesGinsipidus
C.GPrimaryGpolydipsia
D.GTypeG2GdiabetesGmellitusGcorrectGanswersGA.GCentralGdiabetesGinsipidus
CentralGdiabetesGinsipidusGisGtheGmostGcommonGtypeGofGdiabetesGinsipidus,GisGassociatedGwithGdef
icientGsecretionGofGantidiureticGhormoneG(ADH)GbyGtheGposteriorGpituitary.

WhatGisGtheGmostGcommonGpresentingGsymptomGofGbladderGcarcinoma?

A.GNocturia
B.GPainlessGhematuria
C.GUnintentionalGweightGloss
D.GUrinaryGfrequencyGcorrectGanswersGB.GPainlessGhematuria
TheGprimaryGmodalityGtoGdiagnoseGbladderGcancerGisGwithGcystoscopy,GwhichGallowsGforGdirectGvi
sualizationGofGtissuesGandGbiopsyGofGanyGabnormalities.
SmokingGisGtheGmostGimportantGriskGfactorGofGbladderGcancer.

AG25-year-
oldGmanGpresentsGtoGtheGclinicGwithGfeverGandGaGsoreGthroat.GAGthroatGswabGisGperformedGandGtheG
cultureGcomesGbackGpositiveGforGgroupGAGstreptococcusGbacteria.GWhatGsystemGofGhisGbodyGisGatG
highestGriskGforGpermanentGdamageGifGproperGtreatmentGforGhisGinfectionGisGnotGadministered?

A.GCardiovascular
B.GGastrointestinal
C.GMusculoskeletal
D.GPulmonaryGcorrectGanswersGA.GCardiovascular
RiskGofGrheumaticGfeverGandGpericarditis.G
RememberGtheGJonesGcriteriaGforGrheumaticGfever:
Major:GJoints,Gcarditis,Gnodes,GerythemaGmarginatum,GsydenhamGchorea.
Minor:Gfever,Garthralgia,GelevatedGESR,GelevatedGCRP,GandGprolongedGPRGinterval.
NeedG2Gmajor,GorG1GmajorGandG2Gminor,GorG3Gminor

AG60-year-
oldGmanGwithGintermittentGclaudicationGreturnsGtoGtheGclinicGforGinterpretationGofGtheGresultsGofGhi
sGankle-brachialGindex.GWhichGofGtheGfollowingGstatementsGisGmostGaccurate?

A.GAGfalselyGhighGindexGmayGindicateGseverelyGhardened,Gnon-compressibleGlegGvessels
B.GAGlowGankle-brachialGindexGindicatesGperipheralGvenousGinsufficiency
C.GAnGankle-brachialGindexGofG1.2GindicatesGsevereGdisease

,D.GItGisGtheGratioGofGankleGtoGarmGdiastolicGbloodGpressureGcorrectGanswersGA.GAGfalselyGhighGinde
xGmayGindicateGseverelyGhardened,Gnon-compressibleGlegGvessels.G
TheGankle-
brachialGindexGisGcalculatedGbyGmeasuringGtheGsystolicGbloodGpressureGinGtheGarmGandGatGtheGankl
e.GAGratioGofGankleGsystolicGbloodGpressureGtoGbrachialGsystolicGbloodGpressureGunderG0.90GisGindi
cativeGofGperipheralGarterialGdisease.GAGfalselyGhighGankle-
brachialGindexGcanGoccurGwhenGaGpatientGhasGseverelyGhardenedGperipheralGarteriesGwhichGareGno
n-compressible.

AG22-year-
oldGmanGpresentsGtoGtheGofficeGforGhisGoneGweekGfollowGupGafterGhisGthirdGconcussionGinGfourGyea
rs.GTheGpatientGplaysGrugbyGonGhisGcollegeGintramuralGteam.GHisGmostGrecentGconcussionGwasGco
mplicatedGbyGaGperiodGofGlossGofGconsciousnessGatGtheGtimeGofGinjury.GHeGadmitsGtoGhavingGheada
chesGandGintermittentGdizzinessGforGtheGpastGcoupleGofGdays.GHisGheadacheGappearsGtoGbeGtension-
typeGinGnature.GHeGisGeagerGtoGreturnGtoGrugbyGandGisGrequestingGclearanceGtoGplay.GWhichGofGtheG
followingGisGtheGmostGappropriateGeducationGtoGgiveGyourGpatient?

A.GCanGreturnGasGheadachesGafterGaGconcussionGareGexpected
B.GCanGreturnGasGsubsequentGconcussionsGincreaseGresilienceGtoGfutureGones
C.GCannotGreturnGasGpatientGisGcurrentlyGsymptomatic
D.GCannotGreturnGasGpatientGmeetsGcriteriaGforGchronicGtraumaticGencephalopathyGcorrectGanswers
GC.GCannotGreturnGasGpatientGisGcurrentlyGsymptomatic




AG64-year-
oldGmanGpresentsGtoGtheGclinicGreportingGaGprogressiveGtremorGaffectingGhisGhands.GHeGstatesGtheGs
ymptomGonsetGwasGapproximatelyGsevenGyearsGago.GHeGstatesGhisGtremorGisGnowGaffectingGhisGwr
itingGbutGappearsGtoGimproveGinGtheGeveningsGafterGaGglassGofGwine.GHeGhasGnoGsignificantGmedica
lGhistory.GHeGdoesGreportGthatGhisGmotherGhadGaGsimilarGproblemGbutGneverGsoughtGmedicalGattenti
on.GOnGexam,GheGhasGnoGtremorGatGrestGbutGdevelopsGanGincreasingGamplitudeGtremorGinGbothGupp
erGextremitiesGwhenGreachingGforGitems.GNoGbradykinesiaGorGrigidityGisGpresent.GTheGrestGofGhisGe
xaminationGisGunremarkable.GWhichGofGtheGfollowingGisGtheGmostGlikelyGdiagnosis?

A.GEssentialGtremorG
B.GHuntingtonGdisease
C.GParkinsonGdisease
D.GWilsonGdiseaseGcorrectGanswersGA.GEssentialGtremorG
DiagnosisGisGmadeGclinicallyGonGtheGbasisGofGfamilyGhistory,GasGanGautosomalGdominantGtransmiss
ionGoccursGinGmanyGcases,GandGclinicalGpresentation.
InitialGtreatmentGmayGbeGepisodic,GwithGprimidoneGorGpropranolol,Ghowever,Glong-
termGtreatmentGisGusuallyGwithGpropranololGorGtopiramate
ComplainingGofGhandGtremorGthatGisGexacerbatedGbyGactionGandGimprovedGafterGalcoholGconsumpt
ion

WhichGofGtheGfollowingGbestGdescribesGtheGetiologyGofGtheGjaundiceGseenGinGpatientsGwithGthyroid
Gstorm?

,A.GDirectGconstrictingGeffectsGofGthyroidGhormoneGonGtheGbiliaryGduct
B.GHepaticGtissueGhypoxiaGdueGtoGincreasedGperipheralGconsumptionGofGoxygen
C.GHypotensionGleadingGtoGdecreasedGgutGmotility
D.GImpairedGreabsorptionGofGthyroidGhormoneGinGtheGenterohepaticGcirculationGcorrectGanswersGB
.GHepaticGtissueGhypoxiaGdueGtoGincreasedGperipheralGconsumptionGofGoxygen.
SignsGandGsymptomsGofGthyroidGstormGincludeGhyperpyrexia,Gnausea,Gvomiting,Gdiarrhea,GmentalG
statusGchanges,Gjaundice,Ghigh-
outputGcongestiveGheartGfailure,GcardiacGtachyarrhythmias,Ghypertension,GandGdiaphoresis.
PEGwillGshowGgoiter,GlidGlag,GhandGtremor,GandGwarm,GmoistGskin
LabsGwillGshowGlowGTSHGandGhighGfreeGT4GorGT3
MostGcommonlyGcausedGbyGanGacuteGevent
TreatmentGis:G1)GbetaGblockerG(propranolol)G2)GthionamideG(propylthiouracilGorGmethimazole)G3)G
iodineGsolutionG4)Gglucocorticoids

WhichGofGtheGfollowingGisGassociatedGwithGaorticGstenosis?G

A.GdeGMussetGsign
B.GHolodiastolicGdecrescendoGmurmur
C.GSyncope
D.GWideGpulseGpressureGcorrectGanswersGC.GSyncope
PatientGwillGbeGolder
WithGaGhistoryGofGdiabetes,Ghypertension
ComplainingGofGdyspnea,GchestGpain,Gsyncope
PEGwillGshowGcrescendo-
decrescendoGsystolicGmurmurGthatGradiatesGtoGtheGcarotids,GparadoxicallyGsplitGS2,GS4Ggallop
MostGcommonlyGcausedGbyGdegenerativeGcalcification
TreatmentGisGaorticGvalveGreplacement
Comments:GmurmurGdecreasesGwithGValsalva

AG32-year-
oldGwomanGwithGMarfanGsyndromeGisGbroughtGtoGtheGemergencyGdepartmentGbyGherGhusbandGafte
rGsheGexperiencedGaGsyncopalGepisode.GSheGcomplainsGofGacuteGonsetGofGsharpGsubsternalGchestGp
ainGwithGradiationGtoGherGback.GOnGarrival,GherGvitalGsignsGareGTG37.3C,GHRG130,GBPG90/40,GRRG2
7.GTheGbloodGpressureGisGsimilarGinGbilateralGarms.GPhysicalGexaminationGrevealsGnoGjugularGveno
usGdistentionGandGheartGsoundsGareGauscultatedGclearlyGwithoutGmurmurs,Grubs,GorGgallops.GWhich
GofGtheGfollowingGisGtheGmostGappropriateGnextGstepGinGtheGmanagementGofGthisGpatientsGcondition

?

A.GLabetalol
B.GNitroprusside
C.GNorepinephrine
D.GNormalGsalineGcorrectGanswersGD.GNormalGsaline
TheGcauseGofGtheGhypotensionGshouldGbeGdeterminedGandGfirst-
lineGtreatmentGofGhypotensionGinGtheGsettingGofGaorticGdissectionGwithGaorticGruptureGorGtamponad
eGisGfluidGresuscitation
CTGangiogramGisGtheGgoldGstandardGforGdiagnosisGofGdissection.

, AG35-year-
oldGmanGpresentsGtoGtheGofficeGwithGacuteGonsetGrightGflankGpainGradiatingGtoGtheGgroinGwithGinter
mittentGnauseaGandGvomiting.GAGurinalysisGandGcomputedGtomographyGofGtheGabdomenGandGpelvi
sGwithoutGcontrastGwereGordered.GAnGurgentGreferralGforGoutpatientGurologistGevaluationGwouldGbe
GmostGappropriateGforGwhichGofGtheGfollowingGfindings?




A.GAG3GmmGstoneGinGtheGdistalGureter
B.GAG9GmmGmid-ureteralGstone
C.GHydronephrosisGwithGurinaryGtractGinfection
D.GUreteralGobstructionGfromGaGstoneGinGaGtransplantedGkidneyGcorrectGanswersGB.GAG9GmmGmid-
ureteralGstone
StonesGthatGareG<G4GmmGinGdiameterGareGlikelyGtoGpassGonGtheirGownGwithGminimalGmedicalGmana
gement.GStonesGthatGareG>G8GmmGinGdiameter,Ghowever,GareGunlikelyGtoGpassGspontaneouslyGandG
mayGrequireGstentGplacement,GpercutaneousGnephrostomy,GextracorporealGshockwaveGlithotripsy,G
ureteroscopy,GandGnephrostolithotomy.GTherefore,GanGurgentGreferralGforGoutpatientGurologistGeval
uationGisGrecommendedGforGaGpatientGwithGaG9GmmGmid-
ureteralGstoneGwhoGisGlikelyGtoGneedGfurtherGmanagement
TreatmentGis:
<G5Gmm:GlikelyGtoGpassGspontaneously
>G8Gmm:GunlikelyGtoGpass,Glithotripsy

AG35-year-
oldGwomanGpresentsGtoGtheGclinicGcomplainingGofGworseningGsymptomsGrelatedGtoGherGrecentlyGdi
agnosedGsclerodermaG(systemicGsclerosis).GWhichGofGtheGfollowingGsymptomsGisGmostGconsistentG
withGtheGdiagnosisGofGscleroderma?

A.GDryGmouthGandGdryGeyeGcomplaints
B.GSkinGtighteningGaroundGtheGfingersGwithGpittingGatGtheGfingertips
C.GTendernessGatGtheGtemporalGareas
D.GWeaknessGofGproximalGmusclesGwithoutGpainGcorrectGanswersGB.GSkinGtighteningGaroundGtheGf
ingersGwithGpittingGatGtheGfingertips
Classically,GlimitedGcutaneousGsclerodermaGcausesGCRESTGsyndrome;GCalcinosisGofGtheGskin,GRa
ynaudGphenomenon,GEsophagealGdysmotility,GSclerodactyly,GandGTelangiectasia.GLaboratoryGstu
diesGmayGrevealGelevatedGantinuclearGantibodyG(presentGinGallGpatientsGbutGhasGlowGspecificity),Ga
nti-topoisomeraseGIG(anti-Scl-70)GantibodyG(specificGforGdiffuseGdisease),Ganti-
centromereGantibodyG(specificGforGlimitedGdisease).

WhichGofGtheGfollowingGconditionsGisGmostGcommonlyGassociatedGwithGmalarGorG"butterfly"Grash?

A.GParvovirusGB19Ginfection
B.GPregnancy
C.GRosacea
D.GSystemicGlupusGerythematosusGcorrectGanswersGD.GSystemicGlupusGerythematosus
SystemicGlupusGerythematosusGisGmostGcommonlyGseenGinGAfrican-
AmericanGpatientsGofGchildbearingGage.GAntinuclearGantibodiesG(ANA)GisGtheGbestGinitialGscreenin